Dataset Information

Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study.

ABSTRACT:

Objectives

This study examines the association between elder abuse and psychological distress among older adults in India and explores whether this association varies by the level of psychosocial and material resources.

Design

The study uses a cross-sectional survey design.

Setting

The data are drawn from a representative sample of 9589 adults aged 60 and above in seven Indian states-Himachal Pradesh, Punjab, West Bengal, Odisha, Maharashtra, Kerala and Tamil Nadu-in 2011.

Statistical analyses

Secondary analysis, using bivariate and multivariate logistic regression models, is conducted using the United Nations Population Fund project Building Knowledge Base on Ageing in India survey. Elder abuse (physical and/or emotional) emanating from family members in the previous month before the survey is examined. Multivariate models are run on the total analytical sample and for men and women separately.

Results

The overall prevalence of psychological distress among persons aged 60 and over living in the seven Indian States is 40.6%. Among those older persons who experienced some form of physical or emotional abuse or violence in the last month, the prevalence of psychological distress is much higher than that in the general older population, at 61.6% (p<0.001). The results show that the experience of abuse is negatively associated with the mental health of older adults, and this relationship persists even after controlling for demographic and socioeconomic factors (OR=1.60, 95% CI 1.22 to 2.09). The findings also suggest that household wealth has an inverse relationship with mental health, with the association between experiencing elder abuse and reporting poor mental health being strongest among older people in wealthy households.

Conclusions

Elder abuse in India is currently a neglected phenomenon, and greater recognition of the link between abuse and mental health is critical to improve the well-being of vulnerable older adults, some of whom may be 'hidden' within well-off households.

SUBMITTER: Evandrou M

PROVIDER: S-EPMC5665217 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study.

Evandrou Maria M Falkingham Jane C JC Qin Min M Vlachantoni Athina A

BMJ open 20171022 10

<h4>Objectives</h4>This study examines the association between elder abuse and psychological distress among older adults in India and explores whether this association varies by the level of psychosocial and material resources.<h4>Design</h4>The study uses a cross-sectional survey design.<h4>Setting</h4>The data are drawn from a representative sample of 9589 adults aged 60 and above in seven Indian states-Himachal Pradesh, Punjab, West Bengal, Odisha, Maharashtra, Kerala and Tamil Nadu-in 2011.< ...[more]

PMID: 29061615

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Project description:OBJECTIVES:To characterize assessments of a patient's ability to report elder abuse within the context of an emergency department (ED)-based screen for elder abuse. DESIGN:Cross-sectional study in which participants were screened for elder abuse and neglect. SETTING:Academic ED in the United States. PARTICIPANTS:Patients, aged 65 years and older, presenting to an ED for acute care were assessed by trained research assistants or nurses. MEASUREMENTS:All patients completed the four-item Abbreviated Mental Test 4 (AMT4), then completed a safety interview (using the Emergency Department Senior Abuse Identification tool) designed to detect multiple domains of elder abuse and received a physical examination. Based on the cognitive assessment and safety interview, assessors ranked their confidence in the patient's ability to report abuse as absolutely confident, confident, somewhat confident, or not confident. To assess interrater reliability, two assessors independently rated confidence for a subset of patients. RESULTS:Assessors suspected elder abuse in 18 of 276 patients (6.5%). Assessors were absolutely confident in the patient's ability to report abuse for 95.7% of patients, confident for 2.5%, somewhat confident for 1.5%, and not confident for 0.3%. Among patients with an AMT4 of 4 (n = 249), assessors were confident or absolutely confident in 100% of patients. Among patients with an AMT4 of less than 4 (n = 27), they were confident or absolutely confident in the patient's ability to report abuse for 81% of patients, including 11 of 12 patients with mild cognitive impairment and 7 of 11 patients with severe cognitive impairment. For patients receiving paired evaluations (n = 131), agreement between assessors regarding patient ability to report abuse was 97% (κ = 0.5). CONCLUSIONS:In this sample of older adults receiving care in an ED, research assistants and nurses felt that the vast majority were able to report elder abuse, including many patients with cognitive impairment. J Am Geriatr Soc 68:170-175, 2019.

Project description:BackgroundAs the older population aged 65 and over worldwide, is estimated to increase from 9% in 2019 to 16% in 2050, rapid aging will transform the aspects such as economic security, employment status, and family structure. The effects of lower levels of perceived income and poor socioeconomic status on the mental health of older adults appear to be large and enduring. Therefore, the present study contributes to the literature on understanding the association of socioeconomic conditions and self-perceived income status in particular, with self-assessed mental health outcomes (psychological distress and subjective well-being) among older adults in India.MethodsData for the present study was derived from the Building Knowledge Base on Population Ageing (BKPAI) in India. Bivariate and binary logistic regression analyses were conducted to understand the relationship between socioeconomic status and outcome variables.ResultsAbout 43% of older adults had no income whereas 7% had income but perceived as not sufficient to fulfil their basic needs. Nearly, 9% of older adults were retired from regular employment. Almost 70% older adults had received no pension and nearly 18% of older adults had no asset ownership. It is revealed that older adults with income that is partially sufficient to fulfil their basic needs were 2.23 times [OR: 2.23, CI: 1.75-2.84] and 1.96 times [OR: 1.96, CI: 1.55-2.47] significantly more likely to suffer from psychological distress and low subjective well-being than those who had income which was sufficient to fulfil their basic needs.ConclusionsBy focusing on four target areas such as the income support, education, family oriented initiatives and local or regional policies, the current framework for assessing the mental health among older adults in India can be modified. A move towards a guaranteed pension for eligible older individuals by which they do not have to remain as a financial burden on their children, may reduce their self-perceived economic distress and result in higher levels of wellbeing in older ages. Also, strategies to address socioeconomic disadvantages and gender differentials related to mental health status among older population are urgently needed.

Project description:Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency. Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships. Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had happened few or many times) correlate among them. For each of these measures we estimated a multinomial model to examine associations with social support, functional impairments, socioeconomic status, food insecurity, depression, and comorbidities, while controlling for key socio-demographic variables. Results: 30.5% of the older women reported psychological abuse, 8.2% financial exploitation, 5.1% caregiver neglect, 3.5% physical abuse, and 1.2% sexual abuse. In terms of frequency, 77.8% of the women self-reported having never been abused or only once in the last 12 months, whereas 13.1% reported abusive experiences repeating few times, and 9.9% repeating many times. In terms of severity, 66.7% of the older women had not been abused, 22.3% had suffered one type of abuse, and 11.1% two or more. Similarly, 15.0% reported one abusive experience, 8.1% two, and 10.3% three or more abusive events during the last 12 months. Severity measures showed similar associations: social support and high socioeconomic level as protective factors among those with less severe abuse, whereas increased depression, food insecurity and functional impairments were associated with more severe experiences of elder abuse. Frequency followed a different pattern, depressive symptoms were significantly associated with those with few experiences (compared to those with none or once), while functional impairments were associated with many experiences of elder abuse. Conclusions: It is relevant to assess elder abuse through its severity and frequency as inter-individual variability and the complexity of the experience shows different determinants suggesting a syndemic approach. This has important clinical and policy implications.

Project description:BackgroundElderlies are vulnerable to abuse, and evidence suggests that one in three elderlies experience abuse. Abuse can impact the well-being of older persons, decreasing their quality of life, leading to mental health challenges, and increasing morbidity and mortality rates. Evidence on older person/elder abuse and neglect is vital to facilitate initiatives, but there are fewer studies on elder abuse and neglect in Africa, particularly in Uganda. Thus, this study aimed to determine the prevalence of different types of abuse and neglect, and their associated factors among older persons (aged 60 years and above) attending an outpatient clinic.MethodsIn this cross-sectional study, information on sociodemographic characteristics, functional impairment using the Barthel Index, and elder abuse severity using the Hwalek-Sengstock Elder Abuse Screening Test were collected. In addition, types of abuse were assessed using questions adapted from the US National Research Council on elder mistreatment monograph. Linear and logistic regression analyses were used to determine the factors associated with elder abuse severity and the different types of abuse, respectively.ResultsOverall, the prevalence of elder abuse was 89.0%. Neglect was the most common type of elder abuse (86%), followed by emotional abuse (49%), financial abuse (46.8%), physical mistreatment (25%), and sexual abuse (6.8%). About 30.4% of the abused elders experienced at least two forms of abuse. Factors associated with elder abuse severity were having a secondary level of education and physical impairment. Moderate to severe functional dependence was associated with almost all forms of abuse. Individuals who reported the presence of a perpetrator were likely to experience neglect, emotional, and physical mistreatment. However, those who reported their perpetrators to the police had a higher likelihood of experiencing emotional abuse but were less likely to experience financial abuse. Emotional abuse was also associated with age above 80 years and attaining education (primary and secondary). Physical impairment and chronic medical conditions reduced the likelihood of experiencing neglect and financial abuse, and physical abuse, respectively.ConclusionsUganda has a high prevalence of elder abuse and neglect. There is a need to design interventions for older adults at risk to prevent elder abuse from escalating further, where the present findings can be worthy of help.

Project description:ImportanceElder abuse is associated with increased mortality risk. However, the relationship between elder abuse and health care services utilization remains unclear.ObjectiveTo examine the relationship between overall elder abuse and specific subtypes of elder abuse and rate of hospitalization in a community-dwelling population of older adults.DesignProspective population-based study.SettingChicago Health and Aging Project.ParticipantsOf the 6674 community-dwelling older adults who participated in the Chicago Health and Aging Project, 106 were identified by social services agencies for elder abuse.Main outcomes and measuresThe primary predictor was elder abuse (reported and confirmed) reported to social services agency. The outcome of interest was the annual rate of hospitalization obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships.ResultsThe unadjusted mean annual rate of hospitalization was 0.62 (95% CI, 0.59-0.66) for those without elder abuse and 1.97 (95% CI, 1.33-2.61) for those with reported elder abuse. After adjusting for sociodemographic and socioeconomic variables, medical comorbidities, cognitive and physical function, and psychosocial well-being, reported elder abuse had higher rates of hospitalization (rate ratio [RR], 2.00 [95% CI, 1.45-2.75]). Psychological abuse (RR, 2.22 [95% CI, 1.44-3.43]), financial exploitation (RR, 1.75 [95% CI, 1.06-2.90]), caregiver neglect (RR, 2.43 [95% CI, 1.60-3.69]), and 2 or more types of elder abuse (RR, 2.59 [95% CI, 1.82-3.66]) were associated with increased rates of hospitalization, after considering the same potential confounders. Results from interaction term analyses suggested that the association between elder abuse and hospitalization did not differ across the levels of medical comorbidities, cognitive and functional impairment, or psychosocial distress.Conclusions and relevanceElder abuse was associated with increased rates of hospitalization in this community population. Future research is needed to explore the causal mechanisms between elder abuse and hospitalization. As we enter the era of health care reform, an improved understanding of factors that increase rates of hospitalization could also have significant implications for social and health policy as well as clinical care of the vulnerable patients.

Project description:ObjectiveThe study aims to explore the associations of elder abuse, crime victimhood and perceived safety with depression among older adults and examine the interactive effects of sex and place of residence in those associations.DesignA cross-sectional study was conducted using a large survey data.Setting and participantsThe study used data from the Longitudinal Ageing Study in India wave 1 (2017-2018). The effective sample size was 31 464 older adults (aged 60 years or older).Primary and secondary outcome measuresThe outcome variable was major depression, calculated using Short Form Composite International Diagnostic Interview. Descriptive statistics along with bivariate and multivariate analyses were performed to fulfil the objectives.Results5.22% of the older adults (n=1587) experienced abuse in the past 1 year. 1.33% of the older individuals (n=402) were victims of a violent crime, and 14.30% (n=1886) perceived an unsafe neighbourhood. Also, 8.67% of the older adults (n=2657) were suffering from depression. Older adults who were abused had 2.5 odds of suffering from depression (adjusted OR (AOR): 2.47, CI: 1.96 to 3.10) and victims of a violent crime were 84% more likely to be depressed (AOR: 1.84, CI: 1.15 to 2.95) compared with their counterparts. Besides, older individuals who perceived as living in unsafe neighbourhood were 61% more likely to be depressed (AOR: 1.61, CI: 1.34 to 1.93) compared with their counterparts. In the interaction analysis, older women who reported abuse had higher odds of suffering from depression (AOR: 3.27; CI: 2.34 to 4.57) compared with older men who were not abused. Similar result was found in older adults reporting abuse and residing in rural areas (AOR: 3.01, CI: 2.22 to 4.07) compared with those urban residents reporting no abuse.ConclusionsHealthcare providers should pay more attention to the mental health implications of elder abuse, crime victimhood and perceived safety to grasp the underlying dynamics of the symptomology of late-life depression.

Dataset Information

Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study.

Objectives

Design

Setting

Statistical analyses

Results

Conclusions

Publications

Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study.

Similar Datasets

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